Individual provider Active NPI

Amy Barbara Driscoll, MD

  • Pediatrics Physician
  • Greeley, CO
National Provider Identifier
1295821403
Registry record updated Jul 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
47812 Issued in CO
Practice address
5881 W 16TH St
Greeley, CO 80634-2910
Phone
(970) 313-2700
Fax
(970) 313-2727
NPI assigned
Oct 5, 2006
Last updated
Jul 1, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35078997 OH
Pediatrics Physician 208000000X 01054599 IN
Pediatrics Physician 208000000X 47812 CO Primary

Addresses

Primary practice location

5881 W 16TH St
Greeley, CO 80634-2910

Mailing address

5881 W 16TH St
Greeley, CO 80634-2910
Phone (970) 313-2700

Other identifiers 4

IdentifierTypeStateIssuer
78126754MedicaidCO
P00944870OtherCOMEDICARE RAILROAD CARRIER PTAN
200339730MedicaidIN
2277763MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, WY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090724000420 CO Practitioner - Pediatric Medicine 2264585181 Reassigns benefits to 1 organization
I20180206000686 WY Practitioner - Pediatric Medicine 2264585181 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
47812COMDPediatrics Physician
01054599INMDPediatrics Physician
35078997OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ivinson Memorial Hospital CurrentSince Jan 1, 2018 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Sep 13, 2010 Accepting new patients
Ivinson Memorial Hospital CurrentSince Jan 1, 2018 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Sep 13, 2010 Accepting new patients
Major Hospital Past Accepting new patients
Ivinson Memorial Hospital Past Accepting new patients
Uchealth Greeley Hospital Past Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

2121 E Harmony Rd
Unit 100
Fort Collins, CO 80528
Phone (970) 663-3107

1900 16th St
Greeley, CO 80631
Phone (970) 350-2438

5881 W 16th St
Greeley, CO 80634
Phone (970) 313-2700

5881 W 16th St
Ste B
Greeley, CO 80634
Phone (970) 336-1500

6767 29th St
Greeley, CO 80634
Phone (970) 652-2000

6767 29th St
Fl 3
Greeley, CO 80634
Phone (970) 652-2801

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2403

255 N 30th St
Laramie, WY 82072
Phone (307) 742-2141

3116 Willett Dr
Laramie, WY 82072
Phone (307) 742-6319

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372636800000",
    "number": "1295821403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5881 W 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806342910",
            "telephone_number": "970-313-2700",
            "fax_number": "970-313-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5881 W 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806342910",
            "telephone_number": "970-313-2700",
            "fax_number": "970-313-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRISCOLL",
        "first_name": "AMY",
        "middle_name": "BARBARA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2013-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35078997",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01054599",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "47812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78126754",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD CARRIER PTAN",
            "identifier": "P00944870",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200339730",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2277763",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.